Midwife faces charge of manslaughter

Jennifer Crawshaw

In what is possibly the first prosecution of its kind in this country, a midwife is on trial over the death of a baby almost two years ago.

Jennifer Joan Crawshaw, 44, denies the manslaughter of a baby girl at Queen Mary Maternity Centre in March 2004.

The baby had no detectable heart beat for the first 17 minutes after she was born. Her condition deteriorated and, after discussion with her family, her ventilator was switched off.

An autopsy confirmed death was due to brain damage as a result of lack of oxygen at the time of delivery.

In May last year Crawshaw was charged with causing the death through her failure to use reasonable knowledge, skill and care in administering potentially dangerous medical treatment, namely the provision of midwifery services.

Crawshaw's name had been suppressed until the start of the High Court trial in Dunedin yesterday. Justice Panckhurst said that while he had the utmost sympathy for Crawshaw's position, he believed it was not appropriate to grant continued suppression.

But he agreed with Crown and defence lawyers that the name of the family whose baby died should remain suppressed.

He urged the nine women and three men selected to hear the trial to keep an open mind.

Because of the publicity the case had attracted in Dunedin, it was important they made their judgment only on the evidence they heard in court, the judge said.

About a dozen supporters, mainly midwives, were present in the public gallery in support of Crawshaw at yesterday's hearing.

Crown lawyer Marie Grills said it was alleged Crawshaw failed in several respects to exercise the standard of care expected of a lead maternity carer in the circumstances where the baby was the mother's first and was in breech presentation.

In trying to accommodate the mother's desire for a natural birth, she neglected necessary and important obligations and duties and failed to respond in the appropriate way and failed to give the appropriate advice necessary for the baby's safe delivery.

Crawshaw's failure to administer antibiotics to prevent a Group B strep bacteria infection diagnosed in the last weeks of pregnancy showed a significant lack of care when combined with the fact the baby's waters had broken for longer than 18 hours, Mrs Grills said.

Other alleged breaches of her duty were her failure to seek advice on an abnormal fetal heart rate during labour, her failure to seek emergency assistance when the baby's heart stopped beating and her failure to notify both obstetric and paediatric staff of the mother's presence in the labour ward.

This was despite the fact a breech delivery, especially in respect of a first child, was recognised as a high risk delivery for many reasons, Mrs Grills said.

Evidence from medical experts would say that, although the mother's preference was for a natural delivery, it was clear from her birth plan that she had not excluded obstetric involvement if necessary.

The trial comes at a time when midwives and maternity services have been in the public eye after a call by Wellington coroner Gary Evans for an independent review of the Maternity Services Scheme.

Mr Evans recommended a national audit after the deaths of two babies cared for by public maternity services and independent midwives.

- OTAGO DAILY TIMES